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Chronic care management for Medicare beneficiaries

October 1, 2015

About half of all adults — 117 million people — have one or more chronic health conditions, according to the Centers for Disease Control and Prevention. And one of four adults has two or more chronic health conditions.1 Seven of the top ten causes of death in 2010 were from chronic diseases. Two of these chronic diseases — heart disease and cancer — together accounted for nearly 48 percent of all deaths.2

The Centers for Medicare & Medicaid Services (CMS) recognizes chronic care management (CCM) as one of the critical components of primary care that contributes to better health for individuals. CCM services provide aid with appointment scheduling and reminders, medication reconciliation, wellness checks, and much more.

Medicare beneficiaries, who have two or more chronic conditions expected to last at least 12 months, can authorize a physician to coordinate his or her care. If an AmeriHealth Medicare Advantage patient selects you as his or her authorized physician, please review Medical Policy #MA00.006: Care Management and Coordination Services for our coverage position for these services. To view this policy, visit our Medical Policy Portal and select Accept and Go to Medical Policy Online, select the Medicare Advantage tab from the top of the page, and then type the policy name or number in the Search field.

1Ward BW, Schiller JS, Goodman RA. Multiple chronic conditions among US adults: a 2012 update. Prev Chronic Dis. 2014;11:130389.

2Centers for Disease Control and Prevention. Death and Mortality. NCHS FastStats website. www.cdc.gov/nchs/fastats/deaths.htm. Accessed December 20, 2013.


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